While attending medical school, physician Shin Hyun-young learned there are four things that a doctor should do when examining a patient: see (inspection), listen (auscultation), touch (palpation) and tap (percussion).
The doctor, however, is worried she may no longer be able to do what she is supposed to do for her patients if the controversial telemedicine bill goes into effect next year.
“As doctors, there are things that must be done in person in order to make the right diagnosis,” Shin, who also serves as the spokeswoman of the Korean Medical Association, told The Korea Herald. “The idea of telemedicine does not take this into account.”
Shin is one of some 110,000 doctors in South Korea who are against the government’s current plan to introduce telemedicine, the use of information technology through devices such as smartphones in order to provide clinical health care at a distance.
Following the Health Ministry’s announcement of the launch of the long-awaited pilot program for telemedicine services last week, a total of five representative bodies of local health care providers ― doctors, nurses, pharmacists, doctors of traditional Korean medicine and dentists ― immediately protested against the plan.
The members of the groups, some 500,000 in total, are arguing that telemedicine would lower the quality of medical services here and jeopardize the operations of small local clinics and regional hospitals.
If the ongoing pilot program, which kicked off on Sept. 19, proves to be successful, the telemedicine bill will likely go into effect next year. Health care providers estimate that 50,000 medical industry workers will lose their jobs following the legalization of telemedicine.
“We are aware that the current pilot program only involves patients with diabetes or high blood pressure, as well as those with mild medical conditions that do not always require in-person treatment,” Shin said.
“But we have no guarantee that the technology will only be allowed to be used on patients with specific diseases. We consider this telemedicine plan to be a part of the government’s plan to introduce for-profit, IT-driven health care facilities in the country.”
Shin said there are also many unresolved safety concerns about the technology, including risks associated with Internet connection problems, a risk of data leakages, as well as a risk of misdiagnoses.
“What if the patient (who lives in a remote area) loses his or her Internet connection?” she said.
“And as this technology is based on the Internet, there is always the risk of personal data leaks, as well as digital chart mix-ups.”
Each participating patient in the ongoing pilot program is given personal equipment for treatment, such as glucose meters and blood pressure monitors, to monitor their own medical conditions at home and share the information with their doctors during weekly online meetings.
“It is dangerous to just rely on the patients’ accumulated records of their condition to find out the state of their current health,” Shin said.
“Even chronic disease patients always have the risk of developing complications. And this is not always predictable based on their regular checkup results. In-person hospital visits are very often mandatory.”
As for nurses, the government’s telemedicine plan will overlap with the currently available medical service whereby nurses make home visits to patients who are immobile or live in remote areas.
The current law allows telecommunication between health care providers, including doctors and nurses, while it is illegal to provide clinical health care at a distance.
The government said the telemedicine service, if legalized after the pilot program, would especially benefit the disabled, those who live in remote areas and immobile, elderly patients with chronic conditions that need constant medical attention.
“The government does not have legitimate proof that telemedicine can be a better option than what we visiting nurses already offer, who are legally allowed to communicate with doctors at a distance,” said Baek Cheon-ki from the Korean Nurses Association.
For pharmacists and doctors of Korean traditional medicine, it is important to protect smaller local clinics.
“The public has always preferred general hospitals over smaller clinics, and once telemedicine services become available, they would prefer to see doctors who practice in bigger hospitals,” said an official from the Korean Pharmaceutical Association who wanted to remain anonymous.
“And if the smaller local clinics are affected, then small local pharmacies will inevitably be jeopardized as well.”
Meanwhile, there are currently some 20,000 registered doctors of Korean traditional medicine, and more than 80 percent of them practice at small clinics, not general hospitals.
“Because of the specific practices of Korean traditional medicine, such as acupuncture and feeling the pulse for diagnosis, telemedicine is not going to be an option for many of the doctors of Korean medicine,” said Kim Tae-ho from the Association of Korean Medicine. “And we are concerned about how (legalization of telemedicine) is going to affect our practice, as well as our patients.”
By Claire Lee (dyc@heraldcorp.com)
